Princess Eugenie made the brave decision to proudly display her spinal scar on her wedding day, with a dress design that exposed her back.

The newly-married royal had major surgery on her back as a child to treat scoliosis – a potentially debilitating spinal condition.

Princess Eugenie’s surgery was 16 years ago, but she thought it was important not to hide her scar on her wedding day.

‘It’s a lovely way to honour the people who looked after me and a way of standing up for young people who also go through this,’ the Princess told ITV’s This Morning.

‘I think you can change the way beauty is, and you can show people your scars and I think it’s really special to stand up for that.’

What is scoliosis?

Scoliosis is when the spine curves to the side. The spine can also twist at the same time, this can pull the ribcage out of position.

Scoliosis is not a disease, and it can affect people at different points in their lives.

It is not a rare condition, and three to four children out of every 1000 will need specialist treatment for scoliosis.

In most cases, the cause is unknown. But it can be caused by muscular dystrophy or cerebral palsy.

Scoliosis can affect your appearance when the small bones in the spine become twisted.

The twisted vertebrae can pull the ribs round with them, which sometimes causes a lump to form on the back.

People with similar scars were inspired by the Princess’s bold decision, and felt that it was a powerful message about body positivity.

Mel Pollard’s five-year-old daughter Connie was left with a scar on her back after a procedure to fix a tethered spinal cord when she was just 14 months old.

Mel says she can’t wait to show her daughter the pictures.

‘Her scar doesn’t bother her at the moment as she is so young, but I worry about as she gets older she might get self-conscious about it,’ Mel tells Metro.co.uk.

‘Being able to show her now that a real life princess has a scar on her back just like her means she can see it’s nothing to be embarrassed about, and that she should wear her scar with pride.’

Spinal surgery can be a traumatic experience, and the procedure to correct scoliosis is particularly brutal.

Adolescent Idiopathic Scoliosis is the most common form of the condition. For people with scoliosis, the decision over whether to have surgery is often a tough one.

A surgeon will usually analyse the severity of the curve of the spine, and balance that against how much more the individual is likely to grow. If they have finished growing then it reduces the chance that the curve will get worse as they get bigger.

For some people, surgery helps to reduce the pain, but for most, the aim of the operation is to straighten the spine and reduce the visible appearance of scoliosis.

Marc Scott has a similar condition called Scheuermann’s kyphosis, which is a developmental disorder of the spine.

It leads to abnormal growth on the upper back, and can cause the vertebrae in the spine to form a distinct wedge shape.

Marc says Eugenie’s decision was empowering and encouraged him to share his own surgery story.

‘I was diagnosed at 13 and it was a bit chaotic after that. At my first appointment they said I needed surgery now so I was terrified,’ Marc explains.

What happens during scoliosis surgery?

Surgery for scoliosis is called spinal fusion.

Spinal fusion uses metal screws that are attached to the vertebrae in the spine and then connected to a single rod or to two rods.

Bone grafts are placed over the implants, and rods are used to hold the spine in place until it can fuse itself.

Over about a year, the bone graft fuses with the existing bone in the spine and forms a solid column of bone.

Sometimes, if the ribs are prominent, small portions of them can be removed to improve appearance. This is called a costoplasty.

You normally have to stay in hospital for about a week after the procedure.

Scoliosis Association UK

‘I didn’t end up having surgery then – instead I followed special exercises. Supposedly the curvature wouldn’t get worse when I stopped growing – but it did.

‘By age 21, it was so bad that the only option left was surgery. I suffered crippling anxiety in the build up to the operation.

‘It took nine hours, and the recovery was the hardest thing I have ever had to battle.

‘I used to hate the way I looked, as my curvature was really noticeable. I used to get bullied because of it in my teenage years and early adult life.

‘Surgery has changed my life for the better. Now I walk around with confidence and I am mostly pain-free, I just get the odd twinge every now and then.’

Marc thinks it’s really important for high-profile people like Eugenie to share their stories and raise awareness of spinal conditions.

‘I felt like it was just really empowering. With her sharing her story and looking so beautiful in her dress, it made me proud of my scar too.

‘I think if you help just one person by sharing your story, then it is a job well done.’

Others took to Twitter to show how inspired they had been by seeing Eugenie’s scar on display.

I didn’t realise I had anything in common with princess #Eugenie , but this is wonderful. I exposed my #scoliosis scar in my wedding dress, but never thought it beautiful – until now. It’s part of me & I’m lucky to be able to tell the tale! Thank you #NHS https://t.co/jYzK4wMkLj

— Emma (@EmmaL_D) October 12, 2018

So apparently Eugenie rocked her #scoliosis scar out for wedding day. Bit late to this party. I checked into the Royal National Orthopaedic Hospital aged 14. I left with 2 titanium rods, 8 bolts and this boom thoracotomy. 💪🏿 Wear your scars with pride. #spinalfusion pic.twitter.com/rPEUIoRcCA

— Reproductive Justice ✌🏿 (@SoSowemimo) October 13, 2018

But while it was seen as a positive move for many, some people with scoliosis are worried that Eugenie’s scar doesn’t give the full picture of the condition.

Many who develop scoliosis are unable to have surgery to correct their spines because the risks are too high – which can lead to lifelong complications and disability.

Experts warn that surgery complications can include nerve damage, chronic pain, infection, bleeding and even quadriplegia.

Becky Dann is keen to ensure that people like her, who live with the effects of uncorrected scoliosis, have their stories heard too.

‘My scoliosis has meant that I lost movement in my legs, I spent most of my childhood in a wheelchair,’ explains Becky. ‘Now I can walk with a crutch but not far and I still need a wheelchair.

‘A lot of us have to wear body braces from a young age. As I got older my spine collapsed and, because I couldn’t have any more operations, my body twisted and nerves got trapped, meaning my legs stopped working.

‘I managed to regain movement and feeling but my spine is so sensitive now that if it’s knocked it can cause instant paralysis and I’m never sure how long it will last.’

For Becky, the possible complications of surgery were just too dangerous to risk.

‘To have it fixed would have risked death, so it’s not a risk I was willing to take.

‘Its too much trauma for the body as they basically have to reconstruct the spine. There was a chance with me that I’d hemorrhage.

‘It’s not the case for all people who have scoliosis, it very much depends on the severity of it, which is why so many people do have it fixed. It’s not a risk for them.

‘Scoliosis affects a lot of people and not everyone can have it fixed. Some of us spend our childhoods being called names like “hunchback of notre dame” and it’s awful.

‘For those who can’t have it fixed, it causes problems with lungs and unfortunately for some of us, it shortens our life span.

‘But we get on with our lives because we’re normal people living normal lives, just a bit differently.’

Health

Becky did, however, think it was important and positive for Eugenie to show off her surgery scar.

‘I loved the fact Eugenie showed her scar, I felt like it was empowering for a lot of people who also have scoliosis.

‘There are a lot of people fighting for scoliosis to be checked for more because it’s becoming so common, so I hope the light she’s shared on it raises more awareness.’

According to the Scoliosis Association, there are limited treatment options to correct the condition.

‘At the moment spinal surgery is the only proven way of treating scoliosis and correcting spinal curvature, except in the case of very young children and some types of smaller curves, where bracing or casting can be useful,’ it says on their website.

‘Treatments such as physiotherapy and exercise routines can help with pain, and improve posture and flexibility but will not reduce the size of a curve or slow down worsening of the curve.’

MORE: How did Princess Eugenie get the scar on her back as her wedding dress exposes it?